He watched it beat; its choreography was excellent. A fragile dance that dictated life and demise. 

As a third-year medical pupil, Dr Ramakanta Panda, the Chairman of Mumbai’s Asian Coronary heart Institute — a submit he has held for the final decade — stood over a stay beating coronary heart. It was his first time at an open-heart surgical procedure and he was cognisant of his luck. Getting a entrance row seat to a coveted surgical procedure, as this one was uncommon. 

Because the younger Dr Ramakanta watched the surgeon deal with the guts, he stood shocked, amazed, fascinated. This was the organ that orchestrated life. To carry it in a single’s arms was nearly like holding destiny itself. That day, and in that second, he pledged his allegiance to the human coronary heart. “That day made me realise I didn’t wish to do anything,” he says. He’d simply discovered his life’s leitmotif. 

Dr Ramakanta is named ‘India’s most secure coronary heart surgeon’; over 30,000 profitable cardiac surgical procedures color his skilled archives. However right here’s a bout of trivia: his life’s trajectory would have appeared very completely different had his uncle’s coaxing to use for a authorities job labored. 

“There are just a few locations within the nation that carry out coronary heart surgical procedure. What for those who develop into a cardiac surgeon and don’t get into these locations? You’ll lag behind your batchmates,” his uncle dissuaded him from his dream.  

However Dr Ramakanta was adamant. “I’ve determined. I wish to be a coronary heart surgeon. No matter occurs, we’ll see.” In the present day, uncle and nephew share amusing about what performed out all these years in the past. “It’s a very good factor you didn’t hearken to me,” his uncle tells him. And we agree. As a result of that second of defiance gave India its best coronary heart surgeon. 

When’s the final time you checked your coronary heart well being? 

Dr Ramakanta, who’s simply out of surgical procedure, shares that he operated on a 23-year-old affected person who wanted six bypasses. The physician’s considerations about an uptick in coronary heart illness amongst younger sufferers are mirrored by knowledge launched by the World Well being Organisation that means that India is answerable for one-fifth of world cardiovascular disease-related deaths on this planet. 

In keeping with a examine printed in The Lancet, the CVD (cardiovascular illnesses) epidemic in Indians is characterised by a better relative threat burden, an earlier age of onset, larger case fatality and better untimely deaths. To this finish, Dr Ramakanta swears by a four-fold method to dodge the pitfalls of the hustle tradition that has taken the present era by storm. 

The primary secret is train. 

Calling it “the perfect medicines for any human being”, Dr Ramakanta positions it as one thing that isn’t simply helpful for coronary heart well being, but additionally for psychological acumen, immunity, and to cut back the chance of cancers and stroke. Two sorts of train are vital, he emphasises, cardio train — repetitive, rhythmic exercise that will increase your coronary heart fee — and weight coaching. The goal of cardio train, he says, is to get your coronary heart fee to round 85 % of your goal coronary heart fee.

If you wish to know your goal coronary heart fee, subtract your age from 220. This will provide you with your most coronary heart fee (MHR). Multiply this quantity by a share (sometimes 50-85 %) to search out your goal coronary heart fee zone. 

However even while you place significance on train, don’t neglect the warming up and cooling down phases are as vital, Dr Ramakanta factors out. “Individuals who haven’t exercised shouldn’t push themselves abruptly at some point. That might deliver on a coronary heart assault.” 

The second golden rule, he says, is consuming proper. “Go for pure issues, cease every thing synthetic,” he says. The third golden rule is sleep — minimal eight hours. However together with the variety of hours, the time of going to mattress is essential. Dr Ramakanta advises 9 pm – 10 pm.

The fourth golden rule is yoga and meditation, the physician shares. In as we speak’s era, the place fashionable habits defy standard knowledge, the physician urges us to retrace our steps again to the fundamentals.   

‘Everybody believes their coronary heart is the healthiest’

Texas, 4 April 1969 

Dr Denton A. Cooley carried out the world’s first complete synthetic coronary heart implant, a watershed second in medical historical past. That week, the information was plastered onto each science journal cowl the world over. And Dr Ramakanta (in school 9 on the time), who scrambled to learn all of them, feasted his eyes on the information. That medical marvels could possibly be created by merely daring to dream outdoors the confines of the extraordinary fascinated him. The information left an imprint on his psyche. 

By then, the dream of changing into a health care provider had already taken root in his thoughts. The information of the transplant solely compounded it. Rising up in Odisha, Dr Ramakanta, a farmer’s son, was conversant in the accountability that got here with the occupation. Dr Cooley’s experiment made him see how cool docs might actually be. However there’s solely a lot that docs can repair, he realised as soon as he turned one. 

He is at all times amused at how folks assume they’re invincible. 

“The issue is that everyone thinks nothing will occur to their well being. They assume well being issues are issues that have an effect on different folks, and that they’re protected,” he smiles. 

And so, when a affected person walks in, with this mindset, however with their signs suggesting in any other case, Dr Ramakanta instantly appears to be like for predisposing circumstances. 

“These embrace a really robust household historical past of coronary heart illness, circumstances like diabetes, hypertension, being obese, smoking, chewing tobacco, lack of sleep, stress and excessive ldl cholesterol,” he lists them out. 

As an example, within the case of the 23-year-old affected person, he shares {that a} historical past of excessive ldl cholesterol was indicative of coronary heart injury. 

However the catch is that round 50 % of sufferers might not get the traditional signs, Dr Ramakanta factors out. Calling these atypical instances, he explains that, as a substitute of ache within the chest, these folks might expertise ache and discomfort in different areas — the abdomen, the jaw, the wrist, the fingers. That is brought on by a blockage within the nerve that provides the guts, in addition to these areas. 

Your impending coronary heart situation might simply be masquerading as jaw ache or dangerous acidity. 

One other fallacy is that not all coronary heart assaults happen from blockages. “Very often, you get a coronary heart assault from only a ldl cholesterol deposit. The liner of the arteries works to maintain them lubricated. Tobacco use, diabetes, stress, and lack of sleep render the endothelium dysfunctional. As soon as it begins getting broken, delicate ldl cholesterol begins getting deposited inside it. When an individual’s stress ranges enhance, the plaque might rupture, and a clot begins to kind on the rupture web site. Because of this numerous sufferers get a coronary heart assault with out having any crucial blockage,” he explains. 

Have you ever heard concerning the silent coronary heart assault? 

An invisible miscreant, the silent coronary heart assault is a coronary heart assault that happens with little to no signs, or with signs which might be simply mistaken for indigestion, stress, or fatigue, however causes vital injury to the arteries or coronary heart. It’s extra prevalent amongst diabetics, Dr Ramakanta shares. 

Reasoning why, he explains, “Diabetes impacts the nerve endings, which is why diabetics won’t really feel the signs of the silent coronary heart assault.” 

Analysis agrees. “The danger for CAD (coronary artery illness) is 2 to 4 instances larger in diabetic topics, and in Indians, CAD happens prematurely, i.e., one to twenty years sooner than within the West,” reads the findings of a examine which identified that hyperglycemia, central physique weight problems, dyslipidemia, and hypertension and the interaction of those threat components might clarify the enhanced CAD threat in Indians. 

“Preventive measures reminiscent of life-style modification with a nutritious diet, satisfactory bodily exercise, and a lower in stress might assist forestall the dual epidemics of diabetes and CAD,” it learn. 

Managing stress is essential for the present era, Dr Ramakanta notes. 

So how do you handle your stress? 

My query takes him unexpectedly. Whereas he does reveal his secrets and techniques — exercising 5 to 6 days per week, strolling on a treadmill in his workplace, doing half-hour of yoga every day, a vegetarian weight-reduction plan together with brown rice, salads, fruit and veggies, listening to western classical music and previous Hindi numbers (these additionally play throughout his surgical procedures) — he saves the perfect for final: wildlife images. 

The wild is the place Dr Ramakanta actually relaxes. Away from the psychological and bodily toggling his job necessitates, it’s right here that he can let nature dictate his tempo. And nature is aware of the best way. The tug of metaphor is just not misplaced on Dr Ramakanta, who, when at an deadlock throughout a surgical procedure, lets intuition information his selections. Right here’s the place he believes that he’s learnt loads from the wild. 

 As for whether or not he’s ever nervous about surgical procedure, he leaves us with an vital lesson. “Being known as the most secure coronary heart surgeon in India comes with a number of accountability. I deal with each surgical procedure of mine as my first one. Once you’re doing one thing for the primary time, you’re further cautious. You do it with all of your coronary heart.”  

Edited by Vidya Gowri Venkatesh, All photos courtesy Dr Ramakanta Panda 

Sources 

‘Younger Indians With Fatigued Hearts’: by Krish Keswani, Revealed on 17 October 2023.

‘Epidemiology of Cardiovascular Illness in Sort 2 Diabetes: The Indian Situation‘: by the Journal of Diabetes, Science and Expertise, Revealed in January 2010.

‘Heart problems in India: A 360 diploma overview’: by Medical Journal Armed Forces India, Revealed in January 2020.

‘The burgeoning heart problems epidemic in Indians – views on contextual components and potential options‘: by The Lancet, Revealed in Could 2023.